Let Your Hands Do the Talking

Hands are among our most important body parts, but we rarely think about them. As instruments that accomplish our will, it’s difficult to imagine life without them. Think about all our hands do for us throughout our life.

As children, our hands helped us explore and learn about our big, wide world. They steadied us as we learned to walk, caught us as we fell, helped us get back up, and tied our shoes for the first time. Hands feed us and clean us. Their gestures communicate meaning to others. Hands are our most important tools for lifting, carrying, grasping, and manipulating. Our hands use man-made tools for writing, grooming, driving, sports, making music, building, and for every activity in our daily life. We’ve used them to dry the tears of loved ones. Our hands might have a shiny, metallic ring on them as an exclamation to the world that we’ve found the love of our life. They also might have trembled and shook as we held our children for the first time or as we said good-bye to a loved one for the last time.

Our hands have always been there for us. Our hands and faces represent us to others. Our hands are always on display. A large portion of the grey matter in our brain is devoted to the functioning of our faces and hands. Perhaps that’s why they are the two leading characteristics of our body image and self-esteem.

When it comes to our faces, we are experts with our anti-aging routines-cleansers, toners, masks, scrubs, serums, oils, creams, oh my! But when it comes to our hands? Yeah, not so much. Even if we do have an anti-aging hand-care regimen, we often apply it only once or twice a day and rarely reapply after every hand wash. It’s no wonder that our hands can be a dead giveaway of our age. But that needn’t be the case for these sun-exposed appendages that do so much for us.

Hand rejuvenation therapies have been around for years, and help our hands look younger. As we age, skin and soft tissue on the exposed areas of the hands changes (‘tis a cruel joke that the fat seems to leave our hands and go to our stomachs and thighs). Hands lose fullness of contour, and skin elasticity diminishes. Knuckles may appear more prominent. Veins and tendons may impart a bluish color and bumpy texture. Sun exposure and other influences add tan or brown irregular patches or spots, and the skin becomes loose and wrinkled.

Treatment with a soft tissue filler restores lost volume and improves the appearance of aging hands instantly. Radiesse® is a natural product (Merz Pharmaceuticals) that we’ve used successfully for this application. Radiesse® is FDA approved to use with lidocaine (an anesthetic) to reduce discomfort of the injection. The filler is massaged into place and hands appear softer and smoother.

Radiesse® lasts for about a year, so treatment may need to be repeated. However, it has been found that Radiesse® has some long-term benefits as well as. It can actually stimulate natural collagen production in the treatment sites thus helping the skin’s matrix repair itself over time.

Other hand rejuvenation therapies improve skin surface aging: Our GOLD Rx resolves pigment spots and stimulates collagen production within the skin. Laser treatment or Intense Pulsed Light fades surface pigment, and sunblock should also be applied on top of the hands to protect these sun exposed areas and prevent further aging changes.

Greeting others with our hands is a universal element of humanity. Every culture has a greeting involving hands…a hand shake, a wave, a salute. Hands are always on display and should match the age of our face. In caring for your face and body with your hands, don’t forget the hands themselves!

NEW Plastic Surgery: LESS is MORE

Better understanding of aging anatomy is heralding a NEW era of smaller, safer, easy recovery plastic surgical procedures with long lasting changes that essentially prevent an aged appearance for your entire adult life. Even in your sixties, seventies, and eighties, with annual, bi-annual, or semi-annual maintenance and attention to smaller procedures, men and women can manifest youthful vibrance and allure. You’ll NEVER lie about your age, your appearance will do it for you.

Gravitational settling of facial soft tissue is managed by segmental (minor) lifts rather than a full face and neck lift. Cheek lift, temporal brow-lift, eyelid-lift, ear-lobe lift are all office procedures. Even minor face and neck lift operations can be performed safely and comfortably in the office while you’re awake and relaxed. Some skin sagging is corrected by removal and re-arrangement of descending tissue. Examples of this are jowl removal ,lip-lift, and “anguloplasty” (corner of lip lift) procedures. Skin wrinkling can be treated by laser or by filling with fat or off-the-shelf products. Hollows on the aging face create shadows that send a signal of darkness, depression, and sadness. Others interpret this as hostility and avoid you. The face should reflect light, and be bright. Small implants, fat grafting, minor surgical lifts, and off the shelf fillers re-shape surface contours to reflect light in a youthful way.

Choosing minor procedures doesn’t mean they can be performed well by a “minor” cosmetic surgeon. Certification by the American Board of Plastic Surgery means your plastic surgeon has met the highest standard for his or her own performance, which increases the chance that he or she will hold himself or herself to the highest standard for your care and your result.

6 Ways Toward Painless Plastic (Cosmetic) Surgery

Innovative approaches for preventing and controlling pain after cosmetic surgery may be combined to help patients tolerate procedures as much as they will enjoy the result. New methods we incorporate include:

1. Surface (topical) anesthetics before skin injection: These can include Ethyl Chloride, a fine spray that instantaneously freezes the skin, overwhelming nerves that transmit pain impulses with sensation of cold so that subsequent painful stimulus is not recognized. Also, local anesthetics such as benzocaine, prilocaine, lidocaine, and tetracaine are now formulated into creams or gels that promote better penetration through your skin surface to create numbness in the area to be treated. These applications are spread over the area to be treated 20-30 minutes beforehand to allow absorption into the skin. Covering the skin with plastic wrap prevents evaporation, and may improve effectiveness. These skin anesthetics are popular before cosmetic laser and injectable enhancements.

2. Regional anesthetics: These include injection of local anesthetics to neutralize a specific sensory nerve that transmits pain from a specific area of the skin. Lips are among the most highly sensitive areas of your face and body, so this method is valuable before lip augmentation with filler. Dr. Laverson uses topical anesthetic on the skin, then carefully numbs the specific nerves that supply sensation to your lips. This allows completely pain free lip enhancement. Filler must be placed well within the substance of the lips, and topical (surface) anesthetic doesn’t penetrate deeply enough to sufficiently numb your lips without addition of a regional anesthetic to block pain impulses.

3. Cannulas for injection instead of needles: Blunt tipped fine sterile cannulas are now marketed to allow distribution of cosmetic injectables within the face or body without painful needles. These cannulas offer the added benefit of avoiding nerve or blood vessel injury. Sharp needles more easily cut small nerves and vessels beneath the skin, leading to bruising and other side effects. Blunt tipped cannulas, when carefully used, are more likely to push aside these structures, allowing injection to proceed with less trauma to surrounding tissues.

4. Long acting local anesthetics: Use of injectable anesthetics and/or anesthetics to moderate pain for as long as three days after surgery is available thanks to Pacira Pharmaceuticals’ introduction of Exparel®. Now FDA approved, this long acting local anesthetic (bupivacaine) is packaged biochemically as a “liposomal suspension” (within tiny lipid globules) for slow release. Exparel® can be distributed within your tissues before surgical closure. While not totally eliminating post-surgical pain, your discomfort may be reduced to a much more tolerable level. Use of Exparel® may diminish your dependence on narcotic analgesics such as morphine, oxycodone, meperidine, hydromorphone, and hydrocodone, all of which have undesirable side effects.

5. Nausea prevention: One cannot discuss advances in pain control without mentioning nausea prevention. The classically most effective analgesics are narcotic medications which promote nausea, easily their most miserable side effect. First off, if you are nauseated after rhinoplasty, breast implants, or tummy tuck, you’re unable to hold down pain medicine. You’re not only nauseated, but in pain, a difficult combination. Second, if you’re vomiting after nose, face, breast, or liposuction surgery, the entire experience of aesthetic enhancement becomes tainted with bad memories. We plastic surgeons want to prevent nausea and vomiting as much as possible, knowing that if you are miserable, you’re less likely to come back for more. The introduction of anti-nausea medications such as ondansetron (Zofran®), aprepitant (Emend®), scopolamine skin patch (Transderm SCOP®), and alvimopan (Entereg®) combined with traditional anti-nausea treatments droperidol, metoclopramide, and others offer much improved pain control by narcotics and a better surgical experience.

6. Finally, discovery and use of non-narcotic analgesics are helping. Intravenous acetaminophen (Ofirmev®) given toward the end of major surgery, ketorolac (Toradol®) in the recovery room, and tramadol extended release (Ultram® ER) at home to supplement narcotic medications offer significant relief with minimal side effects. Also, muscle relaxers such as Carisoprodol (Soma®) are useful.

Botox is the New Chocolate!

Forget teddy bears, chocolates and flowers– women want Botox, dermal fillers and good skincare. Flowers wilt and chocolates melt. Botox provides a solution to help soften fine lines and wrinkles, lasting for up to 4 months. Dermal fillers smooth out pre-existing lines, and is used to enhance natural features- lasting for up to 2 years. Good skincare products buff away impurities, delivering beautiful, flawless skin.

If your loved one falls into this 78%, we’ve got your covered. Feel Beautiful Plastic Surgery has the works this Valentine’s Day. From Botox and fillers to gift cards and excellent prescription strength skincare, we’ve got it all- so you don’t have to worry. Call us, we’re here to help your loved one Feel Beautiful this Valentine’s Day.

Plastic Surgery for the First Lady?

As we age, facial contours change as a result of mechanical, biochemical, genetic, and environmental processes. These phenomena are noticed by ourselves and by others. Celebrities, including our current first lady, cannot avoid the aging process. Michelle Obama, who recently celebrated her 50th birthday, has had cosmetic procedures and plans to continue using Botox® cosmetic and perhaps having plastic surgery in the future. “Women should have the freedom to do whatever they need to do to feel good about themselves,” the first lady told People magazine.

We couldn’t agree more, Michelle. That’s our philosophy as well: doing whatever it is to make you feel beautiful. As women age, a common question asked is, “How do I restore my youth?” There are many ways to restore your beauty without surgery, although well planned and performed aesthetic procedures offer even more dramatic results.

Restoration of beautiful and/or youthful facial features by injection of fillers, neuromodulator(s), the use of laser, light, and radiofrequency techniques are often used by Dr. Laverson in our Encinitas office. FDA approved cosmetic injectables and energy sources can relax muscles that cause aging wrinkles, fill and smooth existing wrinkles, tighten skin, remove excess or sagging fat, and resurface your complexion to restore youthful allure and glow.

What’s YOUR Resolution ? A Beautiful YOU!

Many New Year resolutions involve commitments to self improvement and a better life. Every January sees gym memberships, sales of diet books, and health club rosters increase. But there are other substantial ways to kick off the New Year with a new you. Cosmetic procedures soar at this time of year, as many people get serious about making changes to feel better, fix limitations, and promote confidence. With both surgical and non-invasive possibilities, Feel Beautiful Plastic Surgery delivers RESULTS. If you’re ready to flatten your stomach, enhance your features, tighten loose skin, or smooth some wrinkles, call us. We want to help.

Juvederm Voluma XC now FDA-Approved Filling & Lifting Cheeks

Juvederm®Voluma™XC is a new, clear hyaluronan gel produced and distributed by Allergan, Inc., Irvine, CA, now FDA approved for augmentation and lifting of aging areas of the cheek. Voluma™ differs from other forms of Juvederm® in molecular cross linking, and this biochemical difference confers longevity, but demands that Voluma™ be distributed more deeply beneath the skin surface than other injectable hyaluronan gels. The product may also be used (off label) to fill small defects and/or augment (enlarge) other areas of the face, breast, and body. Because it is more firm and viscous than Juvederm Ultra XC or Juvederm Ultra Plus XC, Voluma is not recommended for use in the lips.

Results are reversible and last for up to two years. The procedure is non-surgical, associated with minimal risks and/or side effects, and can be accomplished without discomfort during a thirty minute office visit. Voluma™ is packaged in 2 ml syringes, and is more costly than Juvederm XC or

For more information or to schedule appointment, call our office at 858-295-4001 between 9am and 5pm Monday through Friday.

JUVÉDERM VOLUMA™ XC Important Information

INDICATION

JUVÉDERM VOLUMA™ XC injectable gel is indicated for deep (subcutaneous and/or supraperiosteal) injection for cheek augmentation to correct age-related volume deficit in the mid-face in adults over the age of 21.

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS JUVÉDERM VOLUMA™ XC is contraindicated for patients with severe allergies, manifested by a history of anaphylaxis or history or presence of multiple severe allergies, and a history of allergies to gram-positive bacterial proteins or lidocaine.

WARNINGS

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JUVÉDERM VOLUMA™ XC injectable gel must not be injected into blood vessels and should not be used in vascular-rich areas. Use in these areas, such as glabella and nose, has resulted in cases of vascular embolization, occlusion of the vessels, ischemia or infarction, or blindness. Symptoms of vessel occlusion and embolization include pain that is disproportionate to the procedure or remote to the injection site, immediate blanching extending beyond the injected area, and color changes that reflect ischemic tissue such as a dusky or reticular appearance

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Product use at specific sites in which an active inflammatory process (skin eruptions such as cysts, pimples, rashes, or hives) or infection is present should be deferred until the underlying process has been controlled

PRECAUTIONS

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The safety and effectiveness for the treatment of anatomic regions other than the mid-face have not been established

JUVÉDERM VOLUMA™ XC injectable gel should be used with caution in patients on immunosuppressive therapy

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Patients who are using products that can prolong bleeding (such as aspirin, nonsteroidal anti-inflammatory drugs, and warfarin) may experience increased bruising or bleeding at treatment sites

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Patients who experience skin injury near the site of JUVÉDERM VOLUMA™ XC implantation may be at a higher risk for adverse events

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Patients may experience late onset nodules with use of dermal fillers including JUVÉDERM VOLUMA™ XC

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Patients should be limited to 20 mL of JUVÉDERM VOLUMA™ XC per 60 kg (130 lbs) body mass per year. The safety of injecting greater amounts has not been established

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JUVÉDERM VOLUMA™ XC should only be used by physicians who have appropriate experience and who are knowledgeable about facial anatomy and the product for use in deep (subcutaneous and/or supraperiosteal) injection for cheek augmentation

ADVERSE EVENTS Side effects in > 5% of subjects were temporary injection-site tenderness, swelling, firmness, lumps/bumps, bruising, pain, redness, discoloration, and itching. They were predominantly moderate in severity, with a duration of 2 to 4 weeks.